Here is an often overlooked fact about our health care system and how it relates to the Covid Panic News Cycle. A thread

1. Almost all the doctors I spoke to, except in hotspot hospitals in NYC and NJ, the Non-covid census of patients is down 60% or more

2. Part of this is the moratorium on elective procedures. Part of this is patients abstaining from going to the ER for fear of contracting Covid

3. But a big, big chunk of this drop in census is from Emergency physicians, hospitalists and consultants deciding not to admit patients who absolutely don't need to be in the hospital

4. I've been hearing stories of Cardiologists asking ER docs to send patients with mild troponin elevations and/or soft chest pains home after repeat EKG for clinic follow up

5. Many frivolous admits to the hospital are being avoided. Most are being managed int he out patient setting and remotely

6. If, at the end of this pandemic, what if the mortality statistics for non Covid patients show that mortality did not increase significantly?

7. We will find out that the tremendous amount of waste, resource abuse and other frivolous ways of spending our healthcare dollars were never needed in the first place, for marginal or questionable benefits

8. We will then look at ways to make many of these practices permanent.

9. It will come at a tremendous cost to healthcare systems which are addicted to high volume of in and out bread and butter cases and billing optimization practices

10. It will be a big hit for some specialties such as inpatient medicine and consultants dependant on them

11. It will lead to a massive adoption of efficiency and cost savings technologies such as telemedicine and remote diagnosis/treatment

12. In a way, Covid-19 will force us to find efficiencies in our health care system that we were too lazy and inertial to find, before this crisis hit.

13. And a massive force for adoption of technological solutions that have so far been hampered by regulations and perverse incentive structures in healthcare